IFoA SA1 study guide
IFoA SA1 · Work through your exam, one topic at a time.
SA1 - Specialist Advanced: Health and Care is one of the Institute and Faculty of Actuaries' Specialist Advanced (SA) subjects, taken late in the Fellowship pathway after the Core and Specialist Principles stages. It is aimed at actuaries who work with, or advise, health and care insurers, providers, payers or health systems, and who need to exercise judgement rather than apply a single prescribed method. The IFoA SA1 study guide has 8 sections and about 2,684 words.
01Health and care systems, financing and regulation
This domain tests whether you can place a health product inside a funding system - tax-funded, social insurance or voluntary private - and then apply the regulatory constraints that follow. SA1 questions usually give a market scenario and ask for consequences, not a description of the NHS.
395 words, about 2 min02Life and health insurance products, design and pricing
PMI: annual, reviewable, indemnity or network-based; pays for private treatment, not income. Group PMI is experience-rated with credibility weighting.
367 words, about 2 min03Morbidity, mortality and other health-related decrements
Health business is rarely a single-decrement problem. Morbidity incidence, recovery (termination), mortality and lapse compete, so a multiple-decrement table is needed.
293 words, about 1 min04Reserving, capital and solvency for health and care business
This domain tests whether you can build technical provisions and capital for health and care business under Solvency UK, report the result under IFRS 17, and explain the difference between the two. Best estimate liability = PV(expected benefits + expenses) − PV(future premiums), discounted on the risk-free curve, with matching adjustment or volatility adjustment where eligible.
365 words, about 2 min05Asset-liability management and investment for health and care insurers
PMI is short-tailed and repriced annually, so its liabilities are close to cash. Income protection and critical illness are long-tailed: claim duration and reporting lag give a duration of many years, and the claim cost is sensitive to medical inflation, which has historically run above CPI.
317 words, about 2 min06Risk management, reinsurance and capital allocation
Risk appetite statements, a risk register, the ORSA, and stress and scenario testing calibrated to health-specific events: pandemic (morbidity and mortality, plus lapse and NHS disruption), a medical inflation spike, provider failure, claims-handling backlog, and model error. Emerging risks matter for SA1 - antimicrobial resistance, expensive new therapies, genetic data and regulatory change.
303 words, about 2 min07Provider and payer arrangements, including alternative reimbursement models
Fee-for-service: the provider is paid per activity, so volume risk sits with the payer and the incentive is to do more. Capitation: a fixed payment per head per period; utilisation risk moves to the provider, which may under-provide unless quality is monitored.
308 words, about 2 min08Professionalism, ethics and communication of actuarial advice
Actuaries' Code (IFoA): five fundamental principles - integrity, competence and care, impartiality, compliance, and speaking up - supported by technical and professional standards. FRC TAS 100 (principles for technical actuarial work) and TAS 200 (insurance) require you to address data, assumptions, models and communication, and to be transparent about limitations.
336 words, about 2 min